Comparing Population Characteristics, Healthcare Systems and Pharmacists’ Intervention for Elderly between Brazil and United States

Abstract

Specific Aims: The purpose of this study is to compare population characteristics and health care systems between Brazil and United States, learn with each country’s strengths and weaknesses what could be done to improve health delivery and quality of service, as well as to compare the role of the pharmacist in the health organization and the power of the intervention for elderly. Furthermore, there are no published studies that compare these two countries in these related topics, what reinforces the significance of the study. Methods: To compare the Brazilian and American healthcare systems and population characteristics we used specific databases to find the data, such as WHO, CDC, OECD, DataSUS and others. To compare pharmacists’ intervention we analyzed published studies conducted in elderly, for Brazil we did a bibliographic search in Medline/PubMed, Scielo and LILACS, and for U.S. we used a systematic review and meta-analyses by Lee et al. The data was summarized in three tables, one comparing population characteristics, a second comparing the healthcare systems and the third, comparing pharmacists’ roles. Main Results: The population of the United States is about 1.6 times larger than the Brazilian population and with a median age of 36 years against 32.1 years, American population is older. Also, there are more adults aged 65 years or older in U.S. (13.1%) than in Brazil (6.8%). Life expectancy is longer in the U.S. (78.7 against 73.2 years) but there are higher levels of chronic disease among elderly. Much less is spent on health care in Brazil, $990 per capita versus $8362 per capita in U.S. The percent of total health expenditures by each government is about the same, 47% for Brazil and 48% for U.S. According to published data, pharmacists’ activities, practice settings and outcomes measured are more robust in the U.S. Conclusion: Brazil spends much less than the U.S. on health care with small differences in life expectancy and with lower levels of chronic disease. Although United States spends more with healthcare, it does not mean that it has the best system. In the same way, only because Brazil has a public health national coverage, it does not mean that all population needs are met. There is more published data available on American pharmacists and it seems that activities are broader in caring for older adults than in Brazil.